Summary

This study reports minimum 5-year patient reported outcome scores (PROs), RTS and CTS rates for elite female athletes undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS) and compares clinical results with a matched control group of elite male athletes.

Abstract

Background

Few studies have compared outcomes, return to sport (RTS) and continuation of sport (CTS) after primary hip arthroscopy between matched groups of male and female athletes with minimum 5-year follow-up.

The purpose is to report minimum 5-year patient reported outcome scores (PROs), RTS and CTS rates for elite female athletes undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS) and to compare clinical results with a matched control group of elite male athletes.

Methods

Data were prospectively collected and retrospectively reviewed for elite (collegiate or professional) female athletes who underwent primary hip arthroscopy for FAIS by the senior author (X.X.X.) between March 2009 and March 2016. Inclusion criteria were preoperative and minimum 5-year follow-up for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score-Sport Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain. Exclusion criteria were Tönnis grade > 1, hip dysplasia, previous ipsilateral hip surgery/conditions, and those unwilling to participate. Rates of achieving the minimal clinically importance difference (MCID), patient acceptable symptomatic state (PASS), and maximum outcome improvement satisfaction threshold (MOIST) were recorded in addition to RTS. CTS was also recorded and defined as athletes reporting continued sport activity at minimum 5-year follow-up after initial reporting returning to sport. Elite female athletes were propensity-matched in a 1:1 ratio to elite male athletes for comparison.

Results

A total of 81 elite female athlete hips that underwent primary hip arthroscopy met the inclusion criteria, and follow-up was available for 65 (80.2%) at an average of 67.6 ± 6.5 months, with a mean age of 24.3 ± 6.8 years. Female athletes demonstrated significant improvements in all recorded PROs, achieved the MCID/PASS/MOIST at high rates, returned to sport at a rate of 80.4%, and continued sport at a rate of 97.1%. Female athletes demonstrated lower preoperative PROs compared to males, but postoperative PROs, improvement, rates of achieving MCID/PASS/MOIST, and RTS/CTS rates were similar between female and male athletes.

Conclusion

Elite female athletes undergoing primary hip arthroscopy for FAIS demonstrated favorable PROs and high RTS/CTS rates at minimum 5-year follow-up. These results were comparable to those of a propensity-matched control group of elite male athletes.